The Role of Erythrocytes Phosphatidylserine Exposure in Anemia in Peritoneal Dialysis Patients

Abstract

Background. An increased red blood cell (RBC) phosphatidylserine (PS) exposure in uremic patients was found that could promote macrophage recognition and decrease RBC survival time. Furthermore, a reduced red cell life span was found to contribute anemia in patients with renal failure. It is therefore possible to hypothesize that increased PS externalization of RBC may influence renal anemia. The present study preliminarily explored the role of erythrocytes' PS exposure in anemia in uremic patients. Method. Erythrocyte PS exposure was measured in 67 stable patients on continuous ambulatory peritoneal dialysis (CAPD). An investigation was conducted in the relationship between the level of erythrocyte PS exposure and hemoglobin concentration. A flow-cytometric assay based on FITC-Annexin V was used to measure the PS exposure of erythrocytes. Results. An inverse correlation was found between the percentage of PS‐positive RBCs and hemoglobin concentration (r = −0.2601, p < 0.05). Logistic regression analysis revealed that the percentage of PS‐positive RBCs was identified as a risk factor for anemia (Hazards ratio = −0.421, p < 0.05). Conclusion. This study found that elevated PS exposure in erythrocytes might be a risk factor for anemia and contribute to the development of anemia in peritoneal dialysis patients.